The research aims to evaluate the food patterns of two samples in Alexandria and Qena, and its relation to chest disease risks due to air pollution. A random systematic sample consisted of 400 families have been taken from Alexandria (Wadi Elkamar district at Alexandria governorate), and Hiw at Naja Hammadi – Qena governorate. The required data was collected by using an especially design questionnaire, which has four parts include demographic characteristics of the family members, food consumption patterns, the sources of indoors and outdoors air pollution as independent variables, and the prevalence of chest diseases among the family members as a dependent variable. The results show that (47%) of the studied families have patients with chest diseases caused by air pollution, (38%) from Alexandria, while (9%) from Qena. One fourth of patients (25%) are children under 16 years old. The incidence in females is higher in Qena (60%) in comparison to (47.6%) in Alexandria. The   severity of the disease ranged between moderate and severe in Alexandria while in Qena was moderate. The smokers in the families consists (51.5%) and (40%) in Alexandria and Qena respectively. The results reveal that (62%) of families need to modify their food patterns, only (27%) have a healthy food patterns, represents (37%) of Qena sample and (18%) of Alexandria sample. Statistical analysis illustrate a significant negative relation was found between having healthy food patterns (such as eating fruits and whole wheat bread daily, marine fish at least once weekly and drinking daily herbal drinks) and prevalence of chest diseases. Significant positive relation was observed between unhealthy food patterns (more saturated fat and salt) and chest diseases prevalence. Healthy food patterns helps in decrease the prevalence of chest diseases by (17.1%).